Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science 2020)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2050507 Name: Vivek Verma
  Address: 451/Sector-13 451/Sector-13
Telephone No.: Mobile no: 8168921818
E-mail: vviek123@gmail.com  
   
Application fee payment details:  
Payment Status: failure Payment Mode: Online
Amount: ₹ 200 DD Number: -
Issuing Bank: - Transaction Id: 306426235
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050507 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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Date ________________ Date ________________
 
Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2020

 
  Dossier ID: DNS2050507
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Vivek Verma
Mother's Name: Chanderkanta Verma
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 13 Nov 2000 Nationality: Hindu
Place of Birth: Hissar Personal Identification Mark: Birth mark on my neck
Blood Group: B + Address for Communication: 451/Sector-13 451/Sector-13
State: Haryana Country: India
Pin: 125001 City/District: Hissar
Mobile no: 8168921818 Telephone No. with STD code:
Aadhar Card No: E-mail: vviek123@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Dhiraj Verma Relationship with candidate: Father
Parents Date of Birth: 07 Apr 1974 Parent's/Guardian's Occupation/Designation: Govt.Job
   
Office Address:
   
Address: AGM CCC CITY SUBDIVISION.DHBVN AGM CCC CITY SUBDIVISION.DHBVN
Country: India State: Haryana
City/District: Hissar Pin: 125001
Tel: Mobile no.: 7206518808
Fax: Email: dhirajv62@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2020
Board: CBSE Board: CBSE
School: St.marys school School: St.marys school
City: Hissar City: Hissar
English %: 65 Board Roll No./Seat No.:
Aggregate Percentage: 70 School/College Code:
  Centre code:
  Address of School/College: 6 KM TOSHAM ROAD
  Pin: 125001
  Contact Nos:
  Email: dhirajv62@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for IMUCET exam
Why do you wish to join TMI?: Less percentage better aggregate
What are your hobbies?: Badminton
What are your strengths?: My mother
What are your weaknesses?: Confidence
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card not uploaded Class XII marksheet not uploaded
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

___________________

Date ________________

 
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